Neuroblastoma
Differentiation Prognostic marker
Retinoic acid
A B S T R A C TNeuroblastoma is an embryonal pediatric tumor that originates from the developing sympathetic nervous system and shows a broad range of clinical behavior, ranging from fatal progression to differentiation into benign ganglioneuroma. In experimental neuroblastoma systems, retinoic acid (RA) effectively induces neuronal differentiation, and RA treatment has been therefore integrated in current therapies. However, the molecular mechanisms underlying differentiation are still poorly understood. We here investigated the role of transcription factor activating protein 2 beta (TFAP2B), a key factor in sympathetic nervous system development, in neuroblastoma pathogenesis and differentiation. Microarray analyses of primary neuroblastomas (n ¼ 649) demonstrated that low TFAP2B expression was significantly associated with unfavorable prognostic markers as well as adverse patient outcome. We also found that low TFAP2B expression was strongly associated with CpG methylation of the TFAP2B locus in primary neuroblastomas (n ¼ 105) and demethylation with 5-aza-2 0 -deoxycytidine resulted in induction of TFAP2B expression in vitro, suggesting that TFAP2B is silenced by genomic methylation. Tetracycline inducible re-expression of TFAP2B in IMR-32 and SH-EP neuroblastoma cells significantly impaired proliferation and cell cycle progression. In IMR-32 cells, TFAP2B induced neuronal differentiation, which was accompanied by up-regulation of the catecholamine biosynthesizing enzyme genes DBH and TH, and down-regulation of MYCN and REST, a master repressor of neuronal genes. By contrast, knockdown of TFAP2B by lentiviral transduction of shRNAs abrogatedAbbreviations: TFAP2B, transcription factor activating protein 2 beta; DAC, 5-aza-2 0 -deoxyctidine; RA, retinoic acid; INSS, International Neuroblastoma Staging System; INPC, International Neuroblastoma Pathology Committee; MAP2, microtubule associated protein 2; NEFM, neurofilament middle chain; NSE, neuron specific enolase; SYP, synaptophysin; TUBB3, class III beta-tubulin; EFS, event-free survival; OS, overall survival.